TY - JOUR
T1 - Sex-Specific Effects of Nutritional Supplements for Infants Born Early or Small
T2 - An Individual Participant Data Meta-Analysis (ESSENCE IPD-MA) II: Growth
AU - Lin, Luling
AU - Gamble, Greg D.
AU - Crowther, Caroline A.
AU - Bloomfield, Frank H.
AU - Agosti, Massimo
AU - Atkinson, Stephanie A.
AU - Biasini, Augusto
AU - Embleton, Nicholas D.
AU - Filho, Fernando Lamy
AU - Fusch, Christoph
AU - Gianni, Maria L.
AU - Kutman, Hayriye Gözde Kanmaz
AU - Koo, Winston
AU - Litmanovitz, Ita
AU - Morgan, Colin
AU - Mukhopadhyay, Kanya
AU - Neri, Erica
AU - Picaud, Jean Charles
AU - Rochow, Niels
AU - Roggero, Paola
AU - Stroemmen, Kenneth
AU - Tan, Maw J.
AU - Tandoi, Francesco M.
AU - Wood, Claire L.
AU - Zachariassen, Gitte
AU - Harding, Jane E.
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Neonatal nutritional supplements may improve early growth for infants born small, but effects on long-term growth are unclear and may differ by sex. We assessed the effects of early macronutrient supplements on later growth. We searched databases and clinical trials reg-isters from inception to April 2019. Participant-level data from randomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born preterm or small-for-gestational-age. Co-primary outcomes were cognitive impairment and metabolic risk. Supplementation did not alter BMI in childhood (kg/m2: adjusted mean difference (aMD) −0.11[95% CI—0.47, 0.25], p = 0.54; 3 trials, n = 333). Supplementation increased length (cm: aMD 0.37[0.01, 0.72], p = 0.04; 18 trials, n = 2008) and bone mineral content (g: aMD 10.22[0.52, 19.92], p = 0.04; 6 trials, n = 313) in infancy, but not at older ages. There were no differences between supplemented and unsupplemented groups for other outcomes. In subgroup analysis, supplementation increased the height z-score in male toddlers (aMD 0.20[0.02, 0.37], p = 0.03; 10 trials, n = 595) but not in females, and no significant sex interaction was observed (p = 0.21). Macronutrient supplementation for infants born small may not alter BMI in childhood. Supplemen-tation increased growth in infancy, but these effects did not persist in later life. The effects did not differ between boys and girls.
AB - Neonatal nutritional supplements may improve early growth for infants born small, but effects on long-term growth are unclear and may differ by sex. We assessed the effects of early macronutrient supplements on later growth. We searched databases and clinical trials reg-isters from inception to April 2019. Participant-level data from randomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born preterm or small-for-gestational-age. Co-primary outcomes were cognitive impairment and metabolic risk. Supplementation did not alter BMI in childhood (kg/m2: adjusted mean difference (aMD) −0.11[95% CI—0.47, 0.25], p = 0.54; 3 trials, n = 333). Supplementation increased length (cm: aMD 0.37[0.01, 0.72], p = 0.04; 18 trials, n = 2008) and bone mineral content (g: aMD 10.22[0.52, 19.92], p = 0.04; 6 trials, n = 313) in infancy, but not at older ages. There were no differences between supplemented and unsupplemented groups for other outcomes. In subgroup analysis, supplementation increased the height z-score in male toddlers (aMD 0.20[0.02, 0.37], p = 0.03; 10 trials, n = 595) but not in females, and no significant sex interaction was observed (p = 0.21). Macronutrient supplementation for infants born small may not alter BMI in childhood. Supplemen-tation increased growth in infancy, but these effects did not persist in later life. The effects did not differ between boys and girls.
KW - Growth
KW - Individual participants data meta-analysis
KW - Macronutrient supplementation
KW - Preterm infants
KW - Small-for-gestational-age infants
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85122783572&partnerID=8YFLogxK
U2 - 10.3390/nu14020392
DO - 10.3390/nu14020392
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C2 - 35057573
AN - SCOPUS:85122783572
SN - 2072-6643
VL - 14
JO - Nutrients
JF - Nutrients
IS - 2
M1 - 392
ER -